LNCtips.com: LNC Standards

Legal nurse consultants work with nursing standards to determine if the elements of malpractice (duty, breach of duty, causation, and damages) have been met. Knowledge of standards is therefore an integral part of the LNC role.

As a nurse, you're probably familiar with the standards for RN practice promulgated by the American Nurses Association (ANA). But as a legal nurse consultant, are you aware of standards for your practice as an LNC? The American Association of Legal Nurse Consultants (AALNC) has drafted standards that correspond to ANA's. 

Let's take those standards one step further and see how they apply to your LNC practice. We're going to look at a potential claim involving a nursing home resident who developed a decubitus on his right heel. His leg was eventually amputated. The resident went to another nursing home and died there. A plaintiff attorney contemplates filing a lawsuit for resident rights violations and wrongful death. The attorney hires you as an independent LNC to determine if the case has merit.

ANA Standard	AALNC Standard	Application
Assessment	LNC collects data to support the systematic assessment of health care issues related to the case or claim	In this case, data collection includes the medical records of both nursing homes, the hospital where the patient had his surgery, his death certificate, applicable policies and procedures, autopsy report if available, state and federal regulations for long-term care, review of medical literature about pressure ulcer treatment. At this point, you may start a medical chronology or summary.
Analysis and Nursing Diagnosis	LNC analyzes data to identify the health care issues related to a case or claim.	Review above and determine if standards were met for turning patient, nutrition, skin assessment etc. Identify issues and opinions about the case. If creating written work product, incorporate your analysis into your report.
Outcome Identification	LNC identifies the desired outcome of the work product as it relates to the health care issues of a case or claim.	Identify whether the case has merit or not based on the assessment and analysis.
Planning	LNC formulates a plan to achieve the desired outcomes.	Recommend to the attorney things that will enhance the attorney's chances of a successful outcome (assuming that the case has merit) such as recommendations for additional records for review and recommendations for experts.
Implementation (Includes Coordination of Care, Health Promotion, and Consultation)	LNC implements the plan of action.	Actions include such things as interviewing potential experts, verifying credentials, obtaining attorney approval for specific expert(s), sending records to experts as requested by attorney.
Evaluation	LNC evaluates the effectiveness of the plan of action in achieving the desired effect and alters the plan accordingly.	Review the response of the expert (phone conference) to determine if initial issues were correctly identified. Revise plans as needed to pursue the claim.

For more information on standards see ANA Standards of Practice and AALNC Standards of Practice.

...Katy Jones